Interprofessional Model Research Articles

An interprofessional model to improve LGBTQ+ specific cultural competence in dental and pharmacy students.

Disproportionate access to healthcare services among the Lesbian, Gay, Bisexual, Transgender, Queer or Questioning and others (LGBTQ+) population can be partially attributed to the lack of cultural competence among healthcare providers. The aim of this study was to evaluate the impact of an interprofessional model in improving cultural competence and clinical preparedness among dental and pharmacy students for providing LGBTQ+ specific care. This study is a retrospective observational study which used a novel interprofessional model of three different LGBTQ+ focused educational interventions within a group of dental and pharmacy students. The study used pre- and post-surveys, Assessment of Interprofessional Team Collaboration Scale (AITCS-II) and the Team Observed Structured Clinical Encounter (TOSCE) evaluations to assess the effectiveness of the interventions. Descriptive statistics, Fisher's exact test, Wilcoxon signed-rank test, Welch test, Kruskal-Wallis Test, and pairwise Wilcox Test were employed to analyze quantitative data while qualitative insights were gathered from evaluator comments and student feedback. The study evaluated cultural competence among 154 dental and pharmacy students revealing improved cultural humility post-intervention, particularly for dental students although not statistically significant (p>0.05). Students participating in multiple interventions had higher mean scores, but the differences were not significant (p>0.05). Significant differences were found among interprofessional teams of students in the domains of roles and responsibilities (p = 0.039) and patient centered approach (p = 0.039). No significant differences were found in individual scores participation in the teams (p = 0.018). Students also provided positive feedback on the program's impact on their understanding of LGBTQ+ health issues and inclusive care. This program was a novel intervention aimed at improving cultural competence for health professional students in an interprofessional environment Further research in the direction can be useful in creating replicable programs.

Implications of health professionals’ awareness and involvement in oropharyngeal dysphagia management on inpatient outcomes in a National Hospital in Kenya: a case study

IntroductionThe complex, multifaceted nature of oropharyngeal dysphagia calls for all health professionals to be aware and involved in its management. Drawing on the WHO’s Interprofessional Collaboration model, this study assessed...

Development and Implementation of an Online Patient Education Program for Children and Adolescents With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Their Parents, Siblings, and School Personnel: Protocol for the Prospective BAYNET FOR ME/CFS Study.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) presents significant challenges for affected children and adolescents, their social environment, and treating physicians, due to its profound impact on quality of life and the lack of causal therapeutic approaches. One crucial aspect of care that has been missing for these patients is comprehensive education for both them and their social circles. This study protocol aims to outline the goals, study design, execution, and evaluation of the subproject within the BAYNET FOR ME/CFS project. The focus is on developing online education programs for children and adolescents with ME/CFS, as well as for their parents, siblings, and school staff. These programs are designed to improve independent disease management, increase knowledge, and promote interaction with other affected individuals. In phase I, the group-based online education programs were developed by a multidisciplinary team based on the ModuS concept created by the Competence Network for Patient Education (KomPaS). These programs were then piloted and finalized. Phase II involved recruiting participants and implementing the finalized programs. Given the restricted physical and cognitive capacities of the affected individuals, the patient education programs were exclusively designed in a digital format to facilitate participation. In phase III, the programs will be evaluated for acceptance, completeness, and participant satisfaction. The qualitative assessment will focus on individual expectations and benefits derived from the training. Phase IV will further assess the programs in terms of improvements in disease knowledge, health-related quality of life, life satisfaction, and family burden. The programs were developed, piloted, and finalized during phase I, which ran from December 2022 to May 2023. The pilot phase, from March to May 2023, led to adaptations in the program concept. In total, 8 patients and their parents, 5 siblings, and 59 school staff participated in the piloting. Adjustments were made to the format, content, duration, and schedule to better meet the needs of the affected individuals and their social circles. In phase II, participant recruitment for the patient education program took place from January to July 2023. The study successfully recruited 24 young patients with ME/CFS and their parents, along with 8 siblings and 51 school staff. Two program blocks for patients and parents and 2-3 blocks for siblings and school staff commenced in May 2023 and were completed within the same year. Phase III began after phase II and involves the evaluation of the programs, with the process expected to conclude by the end of 2024. Phase IV, planned for 2025-2026, will involve the rollout of the program to 150 children and their caretakers. This phase will focus on evaluating disease knowledge, health-related quality of life, life satisfaction, and family burden, as well as include longitudinal assessments. The data aim to support the development of a comprehensive, interprofessional care model for children and adolescents with ME/CFS. DERR1-10.2196/54679.

Widely Integrated Services in Home (WISH) for homebound older adults: a study protocol for a randomized encouragement trial

BackgroundHome-based primary care (HBPC) is an emerging patient-centered, interprofessional healthcare service model that can address unmet medical needs and care burdens for homebound older adults. In December 2022, the Ministry of Health and Welfare in South Korea launched the Home-Based Medical Center Demonstration project to provide a new bundle payment for physician home visits. In this study, we seek to determine whether the recently introduced HBPC services in South Korea have been associated with a reduction in long-term care (LTC) facility admissions and acute hospitalizations among homebound older adults.MethodsThe study is a community-based, multicenter, two-arm, randomized encouragement design trial with a 12-month follow-up period (n = 600). Eligible study participants are community-dwelling LTC recipients with multimorbidity and functional deterioration. Study participants are recruited from five HBPC centers located in urban areas (Northeast Seoul, West Seoul, Daejeon, Wonju, and Paju). The study participants are randomly assigned to either the HBPC group or the usual care group with a 1:1 allocation ratio. Those assigned to the HBPC group receive longitudinal home visits at least once a month by an interprofessional HBPC team according to the Widely Integrated Services in Home (WISH) intervention protocol. This protocol adheres to the Integrated Care for Older People principles, which call for a person-centered assessment and broader integration of health and LTC services at the micro-, meso- and macro-levels. Primary outcomes of the trial are 1) between-group community survival days and 2) between-group potentially avoidable hospitalizations. Results of the treatment are estimated by both modified intention-to-treat and complier average causal effect analytic methods.DiscussionThis study aims to investigate the real-world effectiveness of HBPC on the reduction of LTC facility admissions and acute care hospitalizations in the community setting. The findings may inform healthcare policy decisions to expand HBPC services in South Korea and other countries.Trial RegistrationCRIS KCT0007921.

Analysis of the Effectiveness of a Fall Prevention Program Incorporating an Interprofessional Team Collaboration Model on Reducing Fall Risk in Elderly Living in Long-term Care Facilities

Concurrent with population ageing, falls have become a significantly more challenging public health issue among older adults. Three years of data collected recently from a nursing home in northern Taiwan reveals an increasing trend in fall density that is primarily associated with aging, physiological decline, chronic diseases, polypharmacy, osteoporosis, and lack of exercise. The percentage of nursing home residents at high risk of falls is currently at 12.6%, and the fall rate has been reported as reaching as high as 30% annually. A fall prevention program was implemented to reduce the fall incidence rate to 18%, with secondary goals of improving fall prevention awareness, behavior, self-efficacy, lower limb muscle strength, balance, and gait by 10% on average, respectively, between pre-test and post-test. From September 30, 2023 to February 29, 2024, a health promotion activity and fall prevention exercise course were implemented using an interdisciplinary team collaboration model over a six-week period, providing individualized exercise for the participants. The study included 20 older adults with an average age of 88 years. Most (90%; n = 18) had chronic diseases, 25% (n = 5) were on more than nine medications, 70% (n = 14) had reduced bone mass, and 40% (n = 8) were at high risk of falls, with a fall incidence rate of 30% during the immediately preceding year. Post-intervention, the fall incidence rate dropped to 5%, fall prevention awareness, behavior, and self-efficacy increased by 18.3%, and lower limb muscle strength, balance, and gait improved by 11.7%. The post-test results in fall prevention awareness, behavioral changes, self-efficacy, and lower limb strength, balance, and gait were all significantly better than pre-test results, with all results achieving statistical significance. The project results support the positive effects of the developed intervention effectively on elderly physical fitness and fall risk, providing valuable insights for the implementation of fall prevention strategies in nursing homes.

Addressing challenges in diagnosis and management of rare disease through interprofessional education

Rare diseases represent a significant public health challenge due to their complexity and lack of resources. One way to improve care for patients with rare disease is to educate healthcare professionals on the diverse and unique needs of patients with rare disorders. An interprofessional education (IPE) event was created for healthcare students based on the Interprofessional Education Collaborative’s ‘IPE Core Competencies', mainly targeting two specific competencies: (1) interprofessional communication and (2) teams and teamwork. The IPE event included direct instruction, case-based learning, and narrative medicine components using the rare disease nephropathic cystinosis as a model of a rare complex disorder. Pre- and post-event survey data were collected to assess the participants' knowledge acquisition and perceived confidence in caring for patients with a rare disease as part of an interprofessional healthcare team and included open-ended questions regarding qualities of an interprofessional team member, and key takeaways from the event. Enrollment included 163 graduate-level healthcare students from nine different disciplines. The survey data showed improved understanding of the importance of rare disease research (p < 0.001), ability to identify supportive resources for patients (p < 0.001), confidence in being part of an interprofessional team caring for a patient with rare disease (p < 0.001) and value of education about rare disease (p = 0.009). When asked to describe features of effective interprofessional teams, common traits included strong communication skills, empathy, compassion, understanding, collaboration, and respect. This work demonstrates that utilizing an interprofessional model in educating health professional students about rare diseases successfully enhanced learners’ confidence in their ability to be part of an interprofessional team caring for patients and families impacted by rare disease, and given the total prevalence of rare diseases, may have a significant impact on healthcare as a whole.

Advancing the Art and Science of Professional Nursing Practice With the Virtually Integrated CareSM Model.

The purpose of this article is to share the transformative vision of 2 nurse executives and how this vision paved the way for the development of a revolutionary model that changed care delivery. The CommonSpirit Health Virtually Integrated Care Team operationalized the vision by leveraging technology to develop a team-based care model that seamlessly integrates a virtual nurse as part of the care team. This article will discuss the spark that created the impetus for the creation of this metamorphic, interprofessional care delivery model and how this model unburdens the workload of the nurses to idealize the art and science of professional nursing practice.

Using an interprofessional decision-making model to determine the level of collaborative decision-making in a virtual learning environment

Medicine and pharmacy students benefit from interprofessional education that supports the learning of collaboration skills for medicines management decision-making. However, if and how students undertake collaborative decision-making processes in interprofessional student teams has not been investigated. The aim of this study was to determine the level to which pharmacy and medical students collaborate to make medicines management decisions in a learning activity. Eight pharmacy and 13 medical students completed a 9-item survey to evaluate a interprofessional learning activity. A secondary analysis of survey data using a deductive approach, according to the Model of Interprofessional Decision-Making was undertaken. Different levels of collaboration were identified in the students’ responses ranging from the first and lowest level in the model, Individual Decision Making, to the fourth and highest level, Shared Decision. Most student responses were categorised as level three-Deliberation. Findings from this study indicate that pharmacy and medical students collaborate to different levels with each other to make patient care decisions. Further examination is required to see if this is usual variation or related to the design of the learning activity.

Implementation of an interprofessional model for the management of postpartum hypertension.

Postpartum hypertension (PPHTN) poses increased risks, including of stroke. Timely assessment and management by clinicians is imperative but challenging. Team-based care involving pharmacists has shown promise in improving blood pressure control, yet its application in PPHTN management remains unexplored. The objective of this study was to determine the impact and feasibility of an interprofessional model for PPHTN management. This initiative implemented a novel interprofessional model at a safety-net hospital to address previous workflow limitations. Ambulatory care pharmacists collaborated with an obstetric nurse (OBRN) and a maternal fetal medicine specialist to manage high-risk patients with PPHTN utilizing electronic consults (e-consults). Data collection and symptom assessment were completed by an OBRN via telemedicine appointments. Pharmacists employed a collaborative practice agreement based on a preestablished algorithm to initiate medications. Data on patient demographics, consult volume, prescriptions, and pharmacist comfort were collected during the first quarter of full integration. Pharmacists completed 55 e-consults and generated 54 prescriptions. The average time spent per chart review was 12.5 minutes, and the average time to completion of e-consults was 54 minutes. Forty-five unique patients received care, who were primarily non-English-speaking and non-Hispanic Black patients. Pharmacists reported moderate to high comfort levels in managing PPHTN based on the algorithm and provided feedback leading to workflow adjustments. Integration of pharmacists into PPHTN care enables prompt medication initiation and titration. This innovative model, involving remote blood pressure monitoring, telemedicine visits with an OBRN, and e-consults completed by pharmacists, ensures delivery of timely and equitable care and improved access across a diverse population.

A Study Protocol for an Interprofessional Model of Care to Prevent and Treat Chronic Disease Using a Nutrition Program Based on Whole Food, Plant-Based Eating Pattern

A Study Protocol for an Interprofessional Model of Care to Prevent and Treat Chronic Disease Using a Nutrition Program Based on Whole Food, Plant-Based Eating Pattern

Interprofessional Education Collaboration between Chung Ang Medical School and Sungshin Nursing School

Interprofessional collaboration is crucial for patient-centered care and safety. Since healthcare students will be part of interprofessional teams in the future, they need to understand the unique contributions of various healthcare professions to patient care and develop skills in collaboration, communication, leadership, and mutual respect. In response to this need, healthcare faculties have adopted interprofessional education as an innovative teaching method. However, traditional health education has typically taken place within individual schools, resulting in a limited understanding of other professional roles and identities. In our study, we introduced an interprofessional education model involving two different colleges. A total of 152 undergraduate students, comprising 101 medical students from Chung Ang University and 51 nursing students from Sungshin Women’s University, participated in the program. A one-day interprofessional education program was conducted to promote collaboration between medical and nursing students. The program included team building and communication games, scenario-based simulations, such as a “room of errors,” and tabletop exercises. Key factors for successful interprofessional education include carefully planned scheduling, leadership, and commitment from participating colleges, faculty support and training, the use of diverse teaching methods and technology, and alignment regarding educational directions among the faculty. We believe that this model may provide valuable insights for healthcare institutions aiming to develop and implement interprofessional curricula.

Facilitating interprofessional learning: experiences of using a digital activity for training handover of critically ill patients between a primary health care centre and ambulance services – a qualitative study

ObjectiveTo explore students’ and facilitators’ experiences of using a developed digital activity for interprofessional learning (IPL) focusing on critically ill patient handovers from a primary healthcare (PHC) centre to the...

An interprofessional model of care for adolescents with perinatal HIV: A qualitative study.

The number of perinatally HIV-infected adolescents (PHIVA) is increasing however many health care systems are not prepared for this population and their health challenges, specifically a model of care (MoC) is lacking. Thus the objective of this study was to develop and propose a MoC for PHIVA. Through a qualitative study design, a MoC was developed and ratified with two focus groups, consisting of PHIVA and healthcare professionals. Seven participants were included in each focus group and the following themes were developed: relatable attributes; missing components; implementation and suggestions. Changes were made to the drafts of the MoC in response to the focus group results, leading to the finalisation of a MoC for PHIVA. The MoC focused on the importance of interprofessional health care and addressed the physical sequelae that PHIVA are likely to encounter. A schematic of the MoC was created for the use in general public education. It is important that healthcare facilities are equipped to handle the specific needs of PHIVA. The interprofessional MoC developed in this study helps to address the requirements of this population.

Navigating Supervision and Interprofessional Relationships in Health Psychology.

Previous literature has focused on either individual models of supervision, developing trainees' interprofessional competencies, or on developing and maintaining interprofessional relationships outside of training. For psychologists in medical settings, these concepts are inextricably linked, and supervision must combine these professional practices to successfully meet the needs of psychology trainees, patients, and interprofessional colleagues, in an increasingly integrated healthcare landscape. This paper presents a model for advancing interprofessional collaborative practice competencies in supervision as health psychology trainees progress through the developmental stages of clinical competency, while supervising psychologists also maintain interprofessional relationships. The Interprofessional Collaboration Supervision Model (IPCSM)for Psychology describes trainee, patient, and interprofessional team factors for supervising psychologists to consider in supervision, as well as various interventions to deploy when these interrelated dynamics impact training. Case examples are provided along with discussion on how to implement this model in supervision.

Defining geriatric care in a developing country: A Multidisciplinary model empowering clinical pharmacists

BackgroundThe elderly population often has complex health needs due to multimorbidity, polypharmacy, and inappropriate prescriptions. Clinical pharmacists play an important role in optimizing pharmacotherapy as a part of a multidisciplinary geriatric care team. However, there is a lack of integrated models in developing countries. AimTo develop a standardized framework for the provision of clinical pharmacy services in geriatric care – A Comprehensive Geriatric Care Model. MethodsA systematic service design process was used to develop an innovative geriatric care model in a tertiary hospital in southern India. The roles of stakeholders were captured through interviews and observations. Evidence-based clinical pharmacy services were developed focusing on medication reconciliation, medication review, patient counselling, and transitions of care. ResultsThe Comprehensive Geriatric Care Model integrates the pharmacist into coordinated care. The responsibilities of physicians, nurses, patients, caregivers, and pharmacists throughout the inpatient stay are shown in swim-lane diagrams. Pharmacy services address inappropriate prescriptions, poor adherence, adverse drug reactions, and fragmented care. ConclusionsThe systematic development of an interprofessional geriatric care model embedded with evidence-based clinical pharmacy services was made possible using a patient-centered service design methodology. The implementation and evaluation of this collaborative approach could significantly improve the quality of care and outcomes for older adults.

Apple Tree Maternity: A Qualitative Exploration of the Development of a Rural Collaborative Interprofessional Maternity Care Service

Introduction: There is currently a maternity care crisis in Canada, with many of the obstetricians and family physicians reaching retirement age in the next 10 years. Primary midwifery care services may offer solutions. However, due to the many constraints and difficulties faced by midwives practicing in rural settings, there is an emerging interest in exploring interprofessional collaborative models of maternity care as a possible solution to the crisis. This study documents the process and experiences of care providers in establishing and providing collaborative interprofessional maternity care in rural British Columbia. Methods: Semistructured interviews were conducted with key stakeholders (primary care providers and allied health professionals) working at Apple Tree Maternity. Interviewees spoke to both the process of establishing a new collaborative interprofessional model of care and the experience of working and providing care within the model. Findings: Four main themes emerged through the dialogue with the stakeholders: motivation for collaboration; challenges and barriers to collaborative care; attributes and benefits of collaborative care; and core qualities and recommendations for successful interprofessional collaboration. Based on their experience of establishing and working within a new model of collaborative, interprofessional, rural maternity care, the study participants identified core qualities and recommendations for successful interprofessional collaboration in a rural community to be mutual trust and respect; common philosophy of care, mutual commitment, and genuine desire to collaborate; clear and effective communication; ensuring the collaborative model is responsive to the unique needs of specific communities; community support; supportive institutional culture; and alternative payment plans and billing structures. Conclusion and implications for practice: This study revealed a number of attributes to collaboration that mirror those identified by others. In addition, study participants identified particular challenges unique to the rural context. Further research documenting the care provider experiences of interprofessional collaboration in other rural settings is warranted. In addition, there is also a need to explore and document the experiences of collaborative practice, in both rural and urban settings, from the client perspective. It is only when this is achieved that significant policy change suggestions should be made that will facilitate both collaborative practice and an improvement in care to women in rural settings. The need for this research is vital given the maternity care crisis in British Columbia and the need for supporting sustainable rural maternity care models. This article has been peer reviewed.

The Rural Interprofessional Health Initiative.

Innovative models that prepare students for careers in rural health are of increasing interest. The UNC Rural Interprofessional Health Initiative (RIPHI) is an intentional interprofessional model that has been in existence since 2017. This article provides an overview of this work, lessons learned, and opportunities for future partnerships.

Impact of an Inter-Professional Clinic on Pancreatic Cancer Outcomes: A Retrospective Cohort Study.

Background: Pancreatic ductal adenocarcinoma (PDAC) presents significant challenges in diagnosis, staging, and appropriate treatment. Furthermore, patients with PDAC often experience complex symptomatology and psychosocial implications that require multi-disciplinary and inter-professional supportive care management from health professionals. Despite these hurdles, the implementation of inter-professional clinic approaches showed promise in enhancing clinical outcomes. To assess the effectiveness of such an approach, we examined the impact of the Wallace McCain Centre for Pancreatic Cancer (WMCPC), an inter-professional clinic for patients with PDAC at the Princess Margaret Cancer Centre (PM). Methods: This retrospective cohort study included all patients diagnosed with PDAC who were seen at the PM before (July 2012-June 2014) and after (July 2014-June 2016) the establishment of the WMCPC. Standard therapies such as surgery, chemotherapy, and radiation therapy remained consistent across both time periods. The cohorts were compared in terms of survival rates, disease stage, referral patterns, time to treatment, symptoms, and the proportion of patients assessed and supported by nursing and allied health professionals. Results: A total of 993 patients were included in the review, comprising 482 patients pre-WMCPC and 511 patients post-WMCPC. In the multivariate analysis, adjusting for ECOG (Eastern Cooperative Oncology Group) and stage, it was found that post-WMCPC patients experienced longer median overall survival (mOS, HR 0.84, 95% CI 0.72-0.98, p = 0.023). Furthermore, the time from referral to initial consultation date decreased significantly from 13.4 to 8.8 days in the post-WMCPC cohort (p < 0.001), along with a reduction in the time from the first clinic appointment to biopsy (14 vs. 8 days, p = 0.022). Additionally, patient-reported well-being scores showed improvement in the post-WMCPC cohort (p = 0.02), and these patients were more frequently attended to by nursing and allied health professionals (p < 0.001). Conclusions: The implementation of an inter-professional clinic for patients diagnosed with PDAC led to improvements in overall survival, patient-reported well-being, time to initial assessment visit and pathological diagnosis, and symptom management. These findings advocate for the adoption of an inter-professional clinic model in the treatment of patients with PDAC.

Integrating Oral Health Care into Primary Care Well Child Visits: An Interprofessional Model of Care

Integrating Oral Health Care into Primary Care Well Child Visits: An Interprofessional Model of Care

Non-dispensing pharmacists integrated into general practices as a new interprofessional model: a qualitative evaluation of general practitioners’ experiences and views

BackgroundA new interprofessional model incorporating non-dispensing pharmacists in general practice teams can improve the quality of pharmaceutical care. However, results of the model are dependent on the context. Understanding when, why and how the model works may increase chances of successful broader implementation in other general practices. Earlier theories suggested that the results of the model are achieved by bringing pharmacotherapeutic knowledge into general practices. This mechanism may not be enough for successful implementation of the model. We wanted to understand better how establishing new interprofessional models in existing healthcare organisations takes place.MethodsAn interview study, with a realist informed evaluation was conducted. This qualitative study was part of the Pharmacotherapy Optimisation through Integration of a Non-dispensing pharmacist in primary care Teams (POINT) project. We invited the general practitioners of the 9 general practices who (had) worked closely with a non-dispensing pharmacist for an interview. Interview data were analysed through discussions about the coding with the research team where themes were developed over time.ResultsWe interviewed 2 general practitioners in each general practice (18 interviews in total). In a context where general practitioners acknowledge the need for improvement and are willing to work with a non-dispensing pharmacist as a new team member, the following mechanisms are triggered. Non-dispensing pharmacists add new knowledge to current general practice. Through everyday talk (discursive actions) both general practitioners and non-dispensing pharmacists evolve in what they consider appropriate, legitimate and imaginable in their work situations. They align their professional identities.ConclusionsNot only the addition of new knowledge of non-dispensing pharmacist to the general practice team is crucial for the success of this interprofessional healthcare model, but also alignment of the general practitioners’ and non-dispensing pharmacists’ professional identities. This is essentially different from traditional pharmaceutical care models, in which pharmacists and GPs work in separate organisations. To induce the process of identity alignment, general practitioners need to acknowledge the need to improve the quality of pharmaceutical care interprofessionally. By acknowledging the aspect of interprofessionality, both general practitioners and non-dispensing pharmacists will explore and reflect on what they consider appropriate, legitimate and imaginable in carrying out their professional roles.Trial registrationThe POINT project was pre-registered in The Netherlands National Trial Register, with Trial registration number NTR-4389.